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NCT04294979Completed

Exercise Therapy in Multiple Sclerosis

Study on the Interaction Between Immune, Autonomic and Central Nervous Systems as a Target of Exercise Therapy in Multiple Sclerosis

Source: ClinicalTrials.gov · Last updated 13 May 2025

Brief summary (registry, in English)

Exercise or active rehabilitation is a non-pharmacological approach increasingly used for people with Multiple Sclerosis (MS), in support of disease-modifying therapies (DMTs), with the aim of improving the quality of life and engagement in daily activities. Exercise improves several disease outcomes, like cardiovascular and neuromuscular functions and walking abilities. However, its disease modifying potential is poorly explored. Exercise might target two relevant disease hallmarks that are interconnected, such as the dysregulated immune system and the inflammatory synaptopathy. Exercise might act through the activation of the autonomic part of the vagus nerve, which is an important modulator of both the innate and adaptive immune system, through the so-called cholinergic anti-inflammatory pathway-CAP. This study aims to address the effect of exercise in reducing peripheral inflammation that drives the synaptic pathology and neurodegeneration occurring in the brain of MS patients. Patients will undergo a therapeutic exercise program, consisting of 3 hours of treatment per day, 6 days/week for a total of 6 weeks. The treatment will include both passive and active therapeutic exercises targeted to restore or preserve muscular flexibility, motor coordination and ambulatory function. The day of recruitment (time 0) patients will undergo neurological and mood examination and blood withdrawal to analyze peripheral markers of immune function. Moreover, transcranial magnetic stimulation (TMS) will be used to measure synaptic transmission, while the heart rate variability (HRV) test will be performed to explore vagal function. The effect of exercise will be evaluated at the end of rehabilitation (after 6 weeks-time 1), on the above parameters. A follow up will be included (time 2, 8 weeks after the end of the treatment) to address long-term effects on neurologic and mood measurements as well as peripheral marker levels.

Status (registry)
Completed
Study type
Interventional
Enrollment
44 (actual)
First submitted
2 Mar 2020
Start date
1 Feb 2020
Primary completion date
1 Dec 2023
Lead sponsor
IRCCS San Raffaele Roma
NCT number
NCT04294979

What you commit to

  • Study type: Interventional
  • Participants enrolled: 44
  • From 1 Feb 2020 to the primary completion date, 1 Dec 2023
  • 1 site in 1 country
  • Visits and tests: ask the trial team, the registry does not list them

Built from the registry fields of ClinicalTrials.gov. It describes the study, not your situation.

Who cannot take part

Copied verbatim from ClinicalTrials.gov and grouped by topic. Only the trial team decides who can take part.

Prior treatment

  • Concomitant use of drugs that may alter synaptic transmission and plasticity (cannabinoids, L-dopa, antiepileptics, nicotine, baclofen, SSRI, botulinum toxin).

Other illness

  • Patients with comorbidities for a neurological disease other than MS, included other neurodegenerative chronic diseases or chronic infections (i.e tuberculosis, infectious hepatitis, HIV/AIDS);
  • Unstable medical condition or infections;
  • Use of medications with increased risk of seizures (i.e. Fampridine, 4- Aminopyridine);

Lab values

  • Altered blood count;

Other

  • Inability to provide written informed consent to the study;
  • Female with a positive pregnancy test at baseline or having active pregnancy plans in the following months after the beginning of the protocol;
  • Contraindications to gadolinium (MRI);
  • Contraindications to TMS;

Who the study is looking for

  • Ability to provide written informed consent to the study;
  • Diagnosis of MS definite according to 2010 revised McDonald's criteria (Polman et al., 2011);
  • Age range 18-65 (included);
  • EDSS range between 4,5 and 6,5 (included);
  • Ability to participate to the study protocol.

Age in the registry: 18 years to 65 years · Sex: All · Accepts healthy volunteers

Full criteria on ClinicalTrials.gov

Sites (1)

Sites in registry order. Pick your city on the disease page to sort them by distance.

SiteCityCountrySite status
IRCCS San Raffele Pisana
Coordinator of this site? Confirm its status
RomaItalyUnknown status

This page is information, not medical advice. Discuss any trial with your doctor.